de Frel Daan L, Zijp Anne, van den Putte Bas, Troelstra Sigrid, Hermsen Sander, Heemskerk Eline, Janssen Veronica R, Atsma Douwe E, Chavannes Niels H, Meijer Eline
Department of Cardiology, Leiden University Medical Center, Leiden, Netherlands.
Public Health and Primary Care, Leiden University Medical Center, Leiden, Netherlands.
Subst Abuse Treat Prev Policy. 2025 May 28;20(1):23. doi: 10.1186/s13011-025-00651-z.
Smoking cessation interventions tend to be less effective for people of lower socioeconomic position (SEP) compared to those of higher SEP. Mobile phone-based interventions have been shown to increase abstinence from smoking. Stopcoach is an mHealth smoking cessation intervention that specifically targets people with a lower SEP. A pilot study showed the potential and feasibility of Stopcoach but as yet no research exists that assesses the effectiveness of Stopcoach.
This study aims to evaluate whether using Stopcoach in combination with group-based smoking cessation counselling (SCC; intervention group) increases short- and long-term abstinence compared to SCC alone (control groups). Secondarily, this study aims to assess acceptability of Stopcoach as perceived by people who smoke and SCC group coaches.
This multi-methods study was originally designed comparing an intervention group (n = 242; 2020-2022) to a historical control group (n = 3362; 2018-2020) that did not use Stopcoach. However, the COVID-19 pandemic hampered realistic comparison due to declining abstinence rates. Therefore, a COVID-era control group was added (n = 312; 2020-2021). All participants enrolled in professionally led SCC groups. The primary outcome was abstinence at four weeks and one year after quit date. In the intervention group, usability, acceptability and usefulness were also measured. In a qualitative assessment, eight SCC trainers were interviewed to explore acceptance by trainers and integration of Stopcoach into SCC.
Due to the COVID-19 related overall decline in abstinence rates, the intervention group had lower abstinence rates compared to the pre-COVID control group (73.6% vs. 78.2% p < 0.001). However, the COVID-era control group revealed that Stopcoach, as addition to accredited SCC, was associated with higher abstinence rates after four weeks than SCC alone (73.6% vs. 57.1%, p < 0.001). This difference was sustained in the lower SEP subgroup (65.6% vs. 49.6%, p = 0.043). No overall significant differences in 1-year abstinence rates were found between the intervention group and both control groups. Participants rated usability, acceptability and usefulness highly positive, irrespective of SEP. Qualitative measures showed most trainers welcomed adding Stopcoach to their SCC.
Addition of the Stopcoach app to SCC appears effective and feasible. Importantly, this also holds for the lower SEP subgroup. This makes Stopcoach one of the few smoking cessation mHealth interventions that also meets the needs of people with lower SEP who smoke.
与社会经济地位较高的人相比，戒烟干预措施对社会经济地位较低的人往往效果较差。基于手机的干预措施已被证明可提高戒烟成功率。Stopcoach是一项移动健康戒烟干预措施，专门针对社会经济地位较低的人群。一项试点研究显示了Stopcoach的潜力和可行性，但目前尚无评估其有效性的研究。
本研究旨在评估与单独使用基于小组的戒烟咨询（SCC；对照组）相比，将Stopcoach与SCC联合使用（干预组）是否能提高短期和长期戒烟成功率。其次，本研究旨在评估吸烟者和SCC小组指导者对Stopcoach的接受程度。
这项多方法研究最初设计为将一个干预组（n = 242；2020 - 2022年）与一个未使用Stopcoach的历史对照组（n = 3362；2018 - 2020年）进行比较。然而，由于戒烟率下降，新冠疫情阻碍了实际比较。因此，增加了一个新冠时代对照组（n = 312；2020 - 2021年）。所有参与者都参加了由专业人员指导的SCC小组。主要结局是戒烟日期后四周和一年的戒烟情况。在干预组中，还测量了可用性、可接受性和有用性。在一项定性评估中，对8名SCC培训师进行了访谈，以探讨培训师的接受程度以及Stopcoach融入SCC的情况。
由于新冠疫情导致总体戒烟率下降，干预组的戒烟率低于新冠疫情前的对照组（73.6%对78.2%，p < 0.001）。然而，新冠时代对照组显示，在获得认可的SCC基础上增加Stopcoach，四周后的戒烟率高于单独使用SCC（73.6%对57.1%，p < 0.001）。这一差异在社会经济地位较低的亚组中持续存在（65.6%对49.6%，p = 0.043）。干预组与两个对照组在一年戒烟率方面未发现总体显著差异。无论社会经济地位如何，参与者对可用性、可接受性和有用性的评价都非常积极。定性测量表明，大多数培训师欢迎在他们的SCC中增加Stopcoach。
在SCC中添加Stopcoach应用程序似乎是有效且可行的。重要的是，这对社会经济地位较低的亚组也适用。这使得Stopcoach成为少数几种也能满足社会经济地位较低的吸烟者需求的戒烟移动健康干预措施之一。
